Individual provider Active NPI

David Edgar Mossop, OD

  • Optometrist
  • Mashpee, MA
National Provider Identifier
1063273308
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5685 Issued in MA
Practice address
107 Commercial St
Mashpee, MA 02649-6507
Phone
(508) 477-7090
NPI assigned
Jan 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5685 MA Primary

Addresses

Primary practice location

107 Commercial St
Mashpee, MA 02649-6507

Mailing address

40 Howard Ave
Bourne, MA 02532-4218
Phone (289) 407-6272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416004380 MA Practitioner - Optometry 3274972757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center of Cape Cod, Inc.Group PAC ID 4486699568, 40 clinicians

Practice addresses (Care Compare)

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-7090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5685MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Cape Cod Inc CurrentSince May 6, 2024 Accepting new patients
Community Health Center of Cape Cod, Inc. Current Accepting new patients
Community Health Center of Cape Cod, Inc. CurrentSince May 6, 2024 Accepting new patients
Community Health Center of Cape Cod, Inc. Past Accepting new patients

Locations

107 Commercial St
Mashpee, MA 02649
Phone (508) 539-6000

Interoperability endpoints

  • Direct secure messaging: dmossop705575@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1063273308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOWARD AVE",
            "city": "BOURNE",
            "state": "MA",
            "postal_code": "025324218",
            "telephone_number": "289-407-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSOP",
        "first_name": "DAVID",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mashpee, MA

Sources for this page

Verify at the official NPI Registry.